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Intravascular Lithotripsy for Common Femoral Artery Occlusive Disease

Pablo Del Canto Peruyera1, Miriam Linares Sánchez1, Andrés Álvarez Salgado1

  • 1Vascular and Endovascular Surgery Department. Cabueñes University Hospital, Gijón, Spain.

Annals of Vascular Surgery
|December 13, 2024
PubMed

Insights

Intravascular lithotripsy (IVL) combined with drug-coated balloons is a safe and effective treatment for common femoral artery disease in patients with chronic limb-threatening ischemia. This approach shows promise as an alternative to open surgery.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapy

Background:

  • Chronic limb-threatening ischemia (CLTI) poses significant challenges in common femoral artery (CFA) treatment.
  • Assessing novel endovascular techniques for CFA disease is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the safety and feasibility of intravascular lithotripsy (IVL) for treating atherosclerotic lesions in the common femoral artery (CFA).
  • To assess the effectiveness of IVL as a standalone or adjunctive therapy in patients with CLTI.

Main Methods:

  • A retrospective analysis of 15 patients with CLTI treated with IVL for CFA disease between September 2021 and April 2023.
  • Standard procedure involved IVL followed by drug-coated balloon (DCB) angioplasty (Paclitaxel or Sirolimus).
  • Primary endpoint: effectiveness of IVL; Secondary endpoints: major adverse events and target lesion revascularization.

Main Results:

  • 100% technical success rate with a mean residual stenosis of 11.88% post-IVL.
  • No need for scaffold placement in any patient.
  • One major adverse event (renal function decline); 0% cumulative clinically driven target lesion revascularization at a mean follow-up of 14 months.

Conclusions:

  • Intravascular lithotripsy (IVL) with adjunctive DCB angioplasty is a safe and feasible option for CFA treatment in CLTI patients.
  • This endovascular approach demonstrates potentially lower morbidity and mortality compared to open surgery.
  • Further long-term studies are warranted to confirm these promising early findings.
Abstract

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